Eskin F, Köseoğlu H, Düzenli T, Özden M, Bebek B, Kaya M, Sezikli M
Department of Internal Medicine, Faculty of Medicine, Hitit University, Çorum, Turkey.
Eur Rev Med Pharmacol Sci. 2023 Mar;27(6):2514-2521. doi: 10.26355/eurrev_202303_31785.
The study aimed to investigate whether the pre-procedural hemoglobin, albumin, lymphocyte, and platelet (HALP) scores can distinguish between benign and malignant causes of obstruction in patients who undergo endoscopic retrograde cholangiopancreatography (ERCP) for extrahepatic biliary obstruction (EBO).
The HALP scores of the patients were calculated according to the values before ERCP. The patients were divided into two groups as malignant and benign according to their diagnosis after ERCP. The HALP scores, demographic characteristics, and some laboratory data of the groups were compared. The cut-off values of the HALP scores were found to detect malignant obstructive causes using the receiver operating characteristic (ROC) curve analysis.
A total of 295 patients had benign and 50 had malignant causes of obstruction among the total of 345 patients. The HALP score was found to be lower in the patient group with malignant biliary obstruction (p = 0.013). The ROC curve analysis was used to determine the diagnostic efficiency, and an area under the curve (AUC) of 0.610 was obtained (0.526-0.693, 95% CI) (p = 0.013). For the HALP score, the sensitivity was found to be 82.4% and the specificity was 30% when a cut-off value of <12.54 was used, and the sensitivity was 61.4% and specificity was 52% when the cut-off value was <21.25.
The study showed that a low HALP score can distinguish malignant causes in patients with EBO. We think that the HALP score, which is a low-cost index that can be easily calculated with simple tests, can be used in this patient population because it may allow early diagnosis of malignant causes in patients with EBO.
本研究旨在调查术前血红蛋白、白蛋白、淋巴细胞和血小板（HALP）评分能否区分因肝外胆管梗阻（EBO）接受内镜逆行胰胆管造影（ERCP）的患者梗阻的良性和恶性原因。
根据ERCP术前患者的各项数值计算HALP评分。根据ERCP术后诊断将患者分为恶性组和良性组。比较两组的HALP评分、人口统计学特征及一些实验室数据。采用受试者工作特征（ROC）曲线分析确定HALP评分检测恶性梗阻原因的临界值。
345例患者中，共有295例梗阻原因是良性的，50例是恶性的。发现恶性胆管梗阻患者组的HALP评分较低（p = 0.013）。采用ROC曲线分析确定诊断效率，曲线下面积（AUC）为0.610（0.526 - 0.693，95%CI）（p = 0.013）。对于HALP评分，当临界值<12.54时，敏感性为82.4%，特异性为30%；当临界值<21.25时，敏感性为61.4%，特异性为52%。
本研究表明，低HALP评分可区分EBO患者的恶性病因。我们认为，HALP评分作为一种低成本指标，通过简单检测即可轻松计算得出，可用于该患者群体，因为它可能有助于EBO患者恶性病因的早期诊断。
